Daijiworld Media Network – New Delhi

New Delhi, Mar 12: Commonly prescribed medicines, particularly painkillers and certain antibiotics, may trigger dyspepsia symptoms in children, according to findings from the EMPACIP study on drug-induced dyspepsia published in the medical journal Cureus in May 2025.

Dyspepsia is characterised by symptoms such as upper abdominal pain, early satiety, epigastric discomfort, flatulence, nausea and vomiting. Medical experts note that such symptoms can be dose-dependent and vary according to factors such as age, sex, genetics and existing health conditions.

According to the ROME IV criteria, functional dyspepsia in adults includes symptoms such as postprandial fullness occurring at least three days per week, early satiety, and epigastric pain or burning lasting for three months, with onset at least six months before diagnosis and no identifiable structural disease. In children, similar symptoms must persist for at least two months after ruling out other medical conditions.

The EMPACIP study involved a panel of 24 paediatric specialists from India who assessed the severity of dyspepsia associated with commonly used medications. The researchers found that Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen and Mefenamic acid — often combined with Paracetamol — were strongly linked to severe dyspeptic symptoms in children.

The study also noted that antimicrobials, corticosteroids and supplements containing iron or zinc may contribute to dyspeptic symptoms, though generally to a lesser extent.

For children experiencing drug-induced dyspepsia, doctors recommend avoiding the medication responsible whenever possible. Acid-reducing medications and prokinetic drugs are typically considered first-line treatment options.

Among acid-reducing medicines, Proton Pump Inhibitors (PPIs) are widely used, though evidence supporting their routine use in children remains limited. Experts warn that PPIs should be reserved for high-risk cases, as combining them with NSAIDs or steroids may increase the risk of side effects, including bone metabolism disturbances, fractures and infections.

Researchers suggested that Histamine-2 Receptor Antagonists (H2RAs) may serve as a safer alternative due to their faster onset of action and favourable safety profile. Medicines such as Ranitidine and Famotidine were recommended by the panel for managing drug-induced dyspepsia.

The experts also advised that routine preventive use of acid-reducing medications with drugs known to cause dyspepsia is not recommended. Instead, such medicines should be used only when symptoms appear and discontinued within 72 hours after the symptoms resolve.